The Context of HIV Risk Among Drug Users and Their Sexual Partners

Unprotected sexual activity is more complicated and difficult to
understand when one partner is an AIDS educator and is aware of
infection precautions. One of Jim’s partners was employed on a study of
male prostitution, HIV, and intravenous (IV) drug use. Jim received his
AIDS education face-to-face from his first “boyfriend.”
“Yeah, he told me about sharing needles. We’d usually buy a
10-pack, but we’d get so tweaked that we’d just grab any one! He
told me to be careful. He told me he’d been at this a long time and
he’d taken a lot of chances, that he didn’t want me to take any
chances. At that time, I didn’t care ‘cause I wanted me and him, it
sounds real stupid and it is real stupid, I figured that if he’s gonna die,
then I want to die! That’s weird, huh?”
Most methamphetamine-using youths have tried at one point or another
to quit and get their “lives in order.” Total cessation of speed use is very
difficult, as reflected in Jim’s account of his first experience with a courtordered
drug treatment program.
“You had to go to groups. Wake up in the morning, go to breakfast
and go to group. After that group, you’d have a small break. After
break, go back to group (laughs). Groups all day long, talking about
your drug history, drug abuse. All it really does is make you want to
use more drugs! Talking about drugs all day, you kind of want to use
them!”
The 6-week treatment program Jim was forced to enter was intended to
discourage him from patterns of drinking and drug use he had known
since childhood. Jim did not take his treatment sessions seriously.
“I didn’t really want to be there in the first place! I told them what
they wanted to hear! I never planned on quitting!”
Jim’s primary partner, Scott, overtly discouraged and yet subtly
encouraged Jim’s substance abuse. Scott took Jim to various treatment
programs in San Francisco without lasting success. Finally, Scott
succeeded in getting Jim to give up alcohol by persuading him that booze
made Jim too contentious and violent. However, speed was tolerable so
as long as Jim refrained from over-amping or using too much of a batch
that was too strong. Jim’s own efforts to stop regular speed use ran
aground because his partner had grown so accustomed to tweaking and
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